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99080157 PERMIT APPLICATION FOR CITY OF CUPERTINO NUMBS INSPECTION DIVISION PERMITEXPIRATION REROOF PERMIT (408)777-3228 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. BUILDING ADDRESS RESIDENTIA COMMERCIAL OTHER OWNER'S; HAZARDOUS FIRE AREA �^ YES ❑ II I understand that a Class A NAME Y S— O Y� l"71- Q k, t awari is required. ' NO Initial LC.B.O.x ADDRESS �� /�— ?a`� e P/ ze� ed EXISTING PHONE ZZ NUMBER OF EXISTING COVERINGS CONTRACTOR'S � / L A TO BE REMOVED TO BE RETAINED I NAME_tA Li IS 16ti1 if ,111-4 C . ADDRESS 1 / TYPE OF ROOF COVERING �7 EXISTING PHONECgQ / ��— 7I(J(�• BUILT-UP ROOF ❑ NUMBER ASPHALT SHINGLES LICENSED CONTRACTORS DECLARATION I hereby affirm Mat I em to need under pro,dephs of Chapter 9(commencing with Si WOOD SHAKES ]000)of Dive on.3 of the Business Shot Profession°Cade,eM my license Is In lull form and effe WOOD SHINGLES License Claes Lk.Number Data Contractor OTHE - OWNER-BUILDER DECLARATION r PR P _ I hereby affirm that I am exempt from Me Contractor's License law for the following reason. _(Sac.7031.5,Business and Professions Code: Arty city or county which require°a permit to construct,after,Improve,demolleh,orrepalr any Structure,prior to Its issuance,also requires the oq G 2 3 1999 applimm for such permit to lie a signed statement that ha h licensed pursuant to the pradalons .BUILT v -5 of the Contractors License Law(Chapter 9(commencing with Section]000)of Division 3 of the !. " Business and Professions Code)or that he Is exempt therefrom and Me bash for the alleged ASPH SHINGLES • exemption.Any violation of Section 7031 S by any applicant for a Permit sublets,the applicant to e civil penalty of not more than fWe hundred dollars($5001.): 0I,as owner of the property,or my employees with wages as Melt sole compensation,will W WOOD the work,and the structure Is not Intended or offered Or sale(Sec.7044,Business and Prefer. stuns Code:The Contractors uconse law does not easy to an owner of property who puddle or WOOD SHINGLES ❑ Improves Mariam,and wte does such work himself or through his own emp"s,provided Met such Improvement°we net Intended or offered for sale.It.however,the bulltlUg or Improvement Is Sold wiMM one year of completion,Me owner-Wilder will haze the burden of proving Mat he did not Wltd OTHER(SPECIFY) E]nor Improve for purpose of sale.). ❑I,ant owner of the property,am exclusively contracting with licensed contractors to construct the project(Sac.7044,Business and Professors Code:The Contractors License Law does not PROVIDE I.C.B.O.REPORT NO. apply to an owner of property wit Wllds or improves theroon,and who contracts Or such protests , with a contractors)licensed pursuant to the Contractors License Lew. PROVIDE MFGR.INSTALLATION SPECS. C1 am exempt under Sec. ,B&P.C.for We reason Owner Det° WORKER'S CORIPENSATION OECLAAATION APPLICATION DATE VALUATION PERMIT FEE I hereby affirm under Penalty of perjury one of the following dedarallon: [:11 have and will maintain a Certificate of Consent to salt-Insure for Workars Compensation, BDlldln as provided for by Section 37W of the Labor Code,for the performance of the work for which MIs g permit is issued. Seismic have end will maintain Worker's C Una w s fix Insurance,as required by Section 3]00 of the pens Code,for ffianc performance of the sank for which this permit ld issued.My Worker's Cartperuasbn Ineumrra carrier and Policy number are: Total Cards, Pi No. P E R M I 0RI7-AT10 NP DATE CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE N.CQ (This section now not be completed If The Permit Is for one hundred dollars($100)or less.) —23— I sentry that In the pertarmarxa of the work for which this permit Is Issued,I shall not employ any person In any manner eo as to become subject to the Workers'compensation laws or Cali- All roofs shall be' spected prior to any roofing material being Iemla. installed. If roof is installed without first obtaining an Date Applicant inspection, agree to remove all new materials for inspection. NOTICE TO APPLICANT: It,after making MIs Cemflcate of Exemption,you should became Applicant understands and will comply with all non point subject to the Workers'Compensation provisions of the Labor Code,you must forthwith comply PP P Y P with such proAsions or MIs permit shall W deemed revoked, source regulations. I certify That I have read this application and state that the above Information Is correct.I agree to comply with.11 cry and county ordinances and state laws relating to building constructor,and All roof coverings.to be class"C"or better. hereby authorize representatNes of this city to enter upon the above-mentioned property for In- _ sp,mgn an,aeae4 (We)agree to aave,indemnify and keep h°rni°va the City of Culbert.a what lot ikues, rydgmar la,costs and expense°which may In any way accrue against said CityIn consequence SIGNATURE OF APPLICANT DATE of the granting of this permit. . PRE-INSPECTION: PLYWOOD: IN-PROGRESS: r INSP. DATE INSP. DATE INSP. DATE TEAR OFF INSPECTION: BATTENS: FINAL: INSP. DATE INSP. DATE INSP. DATE NOTE: OSHA'APPROVED ACCESS TO ROOF SHALL BE PROVIDED FOR INSPECTION OFFICE COPY CITY OF CUPERTINO �m 1 of 1 BUILDING PERMIT RECEIPT OPERATOR: nancyc COPY M 1 Sec: Top: Rng: Sub: Blk: Loc:31626055.00 DATE ISSUED. . . . . . . : 08/23/1999 RECEIPT 4...... . . . : 9896 REFERENCE ID # . . . : 99080157 SITE ADDRESS .. . . . : 10162 PA1,ETT PL SUBDIVISION . .. . . .. CITY . ...... . . . . . .: CUPERTINO IMPACT AREA . . . . . . : - OWNER ..... .. . . . ..: HOY HERBERT H AND BARBARA S ADDRESS .. . . . . ....: CITY/STATE/ZIP . .. : CUPERTINO CA, CA 95014-2208 RECEIVED FROM .... : JOE S CONTRACTOR . . . ... . : LIC 9 COMPANY . . . . . ..... : . ADDRESS . . ........ : CITY/STATE/ZIP ... . TELEPHONE . ....... : FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAD BPERMFEE VALUATION 9,000.00 147.00 0.00 147.00 0.00 BSEISMICRE VALUATION 9,000.00 0.90 0.00 0.90 0.00 PERMIT 147.90 0.00 147.90 0.00 OD OF PAYMENT AMOUNT NUMBER _________________ ____________ __________________ CHECK 147.90 3931 ............ TOTAL RECEIPT 147.90 VOICE ID DESCRIPTION VOICE ID DESCRIPTION ........ ............................ ........ ............................ 305 FRAME 307 INSULATION 601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 603 ROOF BATTENS 604 ROOF IN-PROGRESS • i CITY OF CUPERTINO - BUILDING DEPARTMENT RE-ROOFING POLICY 1. Prior to permit issuance, you must agree to comply with U.B.C. standards and manufacturers specs on re-roofing. 2. New roof coverings shall not be applied without first obtaining all inspections and written approval from the building inspector. A final inspection and approval shall be obtained from the building inspector when the re-roofing is completed. 3. All types of roofs.shall be inspected prior to any roof being installed. 4. In order to receive a final, you must complete steps 1,2, and 3. 1. Pre-inspection or tear-off approval 2. In-progress inspection approval 3. Final inspection approval a. Operable smoke detector verification 5. If plywood is installed, a plywood nail inspection is required. • 6. If any roof is applied without first obtaining an inspection, you will be required to remove all new material down to the sheating and a building inspector will inspect all sheating at that time. IMPORTANT: 1. Flat roofs must have a '/." per foot slope, or demonstrate that there is no ponding. 2. I.C.B.O. reports are required to be on the job site at the time of inspection. If you do not have one, contact the building department. WE UNDERSTAND THE ABOVE POLICY ON RE-ROOFING AND WILL COMPLY WITH THE POLICY. e // HOMEOWNER'S NAME: �r / Y� 1�ca�lJCirec��777D �j ADDRESS: /�( Pr, . I r z � l— l G, L' t2 RE-ROOFING COMPNAY NAME: APPLICANT'S SIGNATURE: . CITY OF CUPERTINO BUILDING DEPARTMENT Re-roofYwinword INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE CITY OF CUPERTINO BUILDING PERMIT INVOICE OPERATOR: nancyc Sec: Twp: Rng: Sub: Blk: Lot:31626055.00 INVOICE DATE...... : 06/23/1999 REFERENCE ID # .. . : 99080157 SITE ADDRESS ..... : 10162 PARLETT PL SUBDIVISION ...... . CITY .. . . ......... : CUPERTINO IMPACT AREA ...... . OWNER . . . . . ....... : HOY HERBERT H AND BARBARA J ADDRESS . . ........ : CITY/STATE/ZIP ... : CUPERTINO CA, CA 95014-2208 CONTRACTOR ....... : LIC # COMPANY . . ........ : ADDRESS . ......... : CITY/STATE/ZIP .. . . TELEPHONE ...... . . : FEE DESCRIPTION CHK TOTAL FEE PAID-TO-DATE BALANCE DUE --------------- --- --------- ------------ ----------- BPERMFEE P 147.00 0.00 147.00 BSEISMICRE P 0.90 0.00 0.90 --------- ------------ ----------- 147.90 0.00 147.90 VOICE ID DESCRIPTION VOICE ID DESCRIPTION .. ............................ ......-- ............................ FRAME 307 INSULATION O1 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL 603 ROOF BATTENS 604 ROOF IN-PROGRESS L 9